Geographic Variation in Human Immunodeficiency Virus Seroconversion Rates in the U.S. Navy

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The Navy population is centered around 19 U.S. home ports and several inland duty stations. This is a study of variation in human immunodeficiency virus (HIV) seroconversions in Navy enlisted men by location in the United States, based on 949, 570 enzyme-linked immunosorbent assays and 812 seroconversions during 1987–90. Seroconversion rates were higher in personnel in San Francisco (p = 0.0004). Washington. D.C. (p = 0.001), and Orlando. FL (p = 0.04) than in other areas. They were lower in Charleston, SC. New London, CT, Seattle; and Brunswick, ME (p < 0.05). Black men had triple the seroconversion rate of all other men (p < 0.0001). After adjustment for race, age, marital status, and occupation, risk of seroconversion remained high in San Francisco (p = 0.02) and Orlando (p = 0.03). The risk of seroconversion in San Francisco was twice that of other areas in a cohort that did not change location (p = 0.01). In contrast to declining trends overall in the Navy, rates did not decrease in Washington, D.C., a result consistent with previous calculations indicating a delayed second wave of HIV infection in the region.

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